Allergy, Asthma & Respiratory Disease

The Korean Academy of Asthma, Allergy and Clinical Immunology (대한천식알레르기학회)
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Comparison of 3 protocols in the methacholine bronchial provocation test

메타콜린 기관지유발검사의 세 프로토콜 비교

  • Sung-Yoon Kang (Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Jiewoo Son (Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Sang Min Lee (Division of Respiratory Diseases and Allergy, Department of Internal Medicine, Dankook University College of Medicine) ;
  • Sae-Hoon Kim (Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Tae-Bum Kim (Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sang Pyo Lee (Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine)
  • 강성윤 (가천대학교 의과대학 가천대학교 길병원 알레르기내과) ;
  • 손지우 (가천대학교 의과대학 가천대학교 길병원 내과) ;
  • 이상민 (단국대학교 의과대학 호흡기알레르기내과학교실) ;
  • 김세훈 (분당서울대학교병원 알레르기내과) ;
  • 김태범 (울산대학교 의과대학 서울아산병원 알레르기내과) ;
  • 이상표 (가천대학교 의과대학 가천대학교 길병원 알레르기내과)
  • Received : 2024.01.03
  • Accepted : 2024.02.27
  • Published : 2024.07.30
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Abstract

Purpose: In Korea, KoKo dosimetry and Aerosol Provocation System (APS) are used in the methacholine provocation test (MBPT). In this study, three protocols of the MBPT were compared. Methods: In patients showing a positive MBPT using short 2-concentration methods for APS with cumulative provocative doses of methacholine which results in a 20% fall in forced expiratory volume in 1 second (FEV1) (PD20) ≤ 962.81, the MBPT was repeated, using 14-breaths methods for APS. In them, PD20 of those 2 protocols were compared to each other. Provocative concentration of methacholine which results in a 20% fall in FEV1 (PC20) in 14-breaths methods was also compared with that of 5-breaths methods in other patients showing a positive MBPT with KoKo dosimettry during the study period. Results: The positive rate in short 2-concentration methods was 18.1% (43 of 238), while that in 5-breaths methods was 14.0% (6 of 43). They were not different from each other (P=0.342). In 7 patients who underwent the MBPT twice, using short 2-concentration and subsequent 14-breaths methods. The median of PD20 with a positive MBPT using short 2-concentration methods was 573.8 ㎍ with interquartile range (IQR) of 147.8-682.3 ㎍, whereas that in repeated MBPT using 14-breaths methods was 526.4 ㎍ (IQR, 95.0-907.1 ㎍). They did not differ from each other (P=0.735). The median of PC20 in MBPT using 14-breaths methods was 4.76 mg/mL (IQR, 0.066-10.3 mg/mL) tended to be higher than that in other 6 patients who showed a positive MBPT using 5-breaths methods, 1.95 mg/mL (IQR, 0.42-4.85 mg/mL), but it was not significant (P=0.534). Conclusion: Bronchial hyperresponsiveness was not different in 3 protocols of MBPT.

Keywords

Acknowledgement

This research was supported by a grant of Gachon University Gil Medical Center (GCU-202308910001) and the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0481, HC20C0076).

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